Siri: iPhone’s new personal health assistant?

By: Brian Dolan | Oct 20, 2011        

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Brian Dolan, Editor, MobiHealthNewsWhen Apple announced its newest iPhone, the 4S, its most notable new feature was Siri, a voice-enabled virtual assistant. Apple acquired the company that created Siri in April 2010, just a few months after the startup’s app went live in the AppStore. Apple further refined Siri through a partnership with Nuance, a speech recognition company that should be familiar to those in healthcare. Dictation, transcription, and — more recently — speech recognition services, have long been staples of the practice of medicine.

Based on our own in-house testing here at MobiHealthNews, Siri in its current form could be helpful to both patients and healthcare providers alike. After asking Siri a number of questions, we were surprised how she answered some and that she was able to answer others.

We are not alone in thinking that Siri could be helpful to the health-conscious. The promo video that Apple put together for its new personal assistant begins with a runner using Siri to check his messages while mid-stride. The video ends with a visually impaired user who is able to use Siri via voice commands alone to send and receive messages.

Siri’s current functionality is limited to a handful of apps:

“Siri on iPhone 4S lets you use your voice to send messages, schedule meetings, place phone calls, and more,” Apple writes on its corporate site. “Ask Siri to do things just by talking the way you talk. Siri understands what you say, knows what you mean, and even talks back. Siri is so easy to use and does so much, you’ll keep finding more and more ways to use it.”

The limited menu that Siri accommodates today reminds me of the limited native apps that Apple launched with its first iPhone. At the time there was no AppStore. No third party native apps. The new smartphone offered just a hint of what was to come.

Prediction: Siri will come out of “beta” once Apple is ready to share its API with developers. I think this will happen within a year’s time. Voice-enabled commands for health apps could make them easy enough for almost anyone to use.

In the mean time, be sure to check out how Siri responded to the half dozen questions and commands MobiHealthNews sent its way. We think there may be a few health apps and mobile health services that might be in trouble if Siri catches on. Reminders for medication? Check. Directions to the closest emergency room? Check.

Read on for a number of health-related questions our assistant editor Chris Gullo asked of Siri. Who knew she could look up billing codes for medical procedures?

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California law, Mercy investment bode well for telehealth

By: Neil Versel | Oct 20, 2011        

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Neil VerselTelehealth is on a roll this month.

Last Friday, California Gov. Jerry Brown signed into law a bill that makes it much easier for patients to access telehealth services and for practitioners to deliver care remotely. The Telehealth Advancement Act, which takes effect Jan. 1, broadens the state’s definition of telehealth providers to include all licensed healthcare professionals and removes the rule that physicians be independently credentialed by every hospital they provide telehealth services to, according to KION-TV, Salinas, Calif.

The law also does away with a requirement that physicians provide the state with documentation that there is a barrier to a patient making an in-person doctor visit and that each patient provide an extra consent form for telemedicine services.

“This new act enables healthcare providers to take better advantage of telehealth technology for preventative and specialized care that will save and enhance the lives of many Californians,” Christine Martin, executive director of the California Telemedicine and eHealth Center, says in a press release.

Perhaps the most impressive part is the fact that the legislation was bipartisan, championed by Republican Assembly Member Dan Logue and signed by a Democratic governor after passing without opposition. That speaks to the potential of remote care.

Purely by coincidence, telehealth, wireless and mobile health got another shot in the arm in California and beyond, Gary and Mary West, benefactors of the West Wireless Health Institute near San Diego, announced a long-awaited healthcare investment fund. As MobiHealthNews reports this week, the Wests have committed $100 million to the West Health Investment Fund.

It wasn’t the only huge commitment of cash to remote healthcare technologies in October. Last week, the Mercy healthcare system unveiled plans to build a $90 million “virtual care center” near its Chesterfield, Mo., headquarters. The center will allow the Catholic healthcare organization to ramp up round-the-clock telehealth services to its 30 hospitals and more than 200 ambulatory care facilities across four states.

Plans are to expand what Mercy already calls the largest remote ICU in America and to bring telestroke services to all of its emergency departments. The health system has other telehealth services planned, including teleradiology, telepathology, specialist support for primary care, nurses on call via phone or email and, yes, remote disease management. The latter will incorporate various home-based monitoring devices that will automatically connect to an electronic health record.

By the way, Mercy says it will put an additional $590 million into technology to support the telehealth center.

But there’s still one key barrier to wider deployment of interstate telehealth services. Many states won’t allow remote physicians to deliver services within their boundaries unless the practitioner is licensed in the state where the patient is located. Well, the American Telemedicine Association wants to change that. The organization has launched a petition drive at to convince Congress and state medical boards to allow license portability for telehealth services. (One tip to the ATA, there hasn’t been a “Veterans Administration” since 1989. It’s a common mistake, but it doesn’t make you look good.)

With the amount of momentum that telehealth has picked up in the last couple of weeks, now is as good a time as any to get to work on changing these archaic restrictions.

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App to help physicians screen for domestic abuse

By: Neil Versel | Oct 20, 2011        

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Abuse Screening AppA Florida domestic violence shelter and treatment facility has created what it calls the first smartphone app to screen patients for symptoms of abuse. The R3 App, which stands for “recognize, respond and refer,” will be available for free for the iPhone, iPad and Android devices in the coming weeks.

Created by Orlando-based Harbor House of Central Florida, the app incorporates the “HITS” process for screening, developed by Dr. Kevin Sherin in 1998, before he went on to become director of the Orange County, Fla., Health Department in Orlando. The process asks suspected victims of abuse how often in the previous 12 months their partners: physically hurt them; insulted them; threatened physical harm; and screamed or cursed at them.

Like the test itself, the app asks patients to assign a score of 1 to 5 regarding the frequency of occurrences. With the app, any score of at least 13 of a possible 20 points alerts a healthcare professional who can help and provides the screening physician with the address of nearby shelters for victims of domestic violence.

“We know that 85 percent of women who have been abused report that they want to tell their doctor, so if we actually have physicians who, because of this app, can now screen not just when they suspect, but every single time that they see a patient, we could potentially save thousands and thousands of lives,” Harbor House CEO Carol Wick says in a video provided by Florida Hospital. The Orlando-based health system, which funded development of the app, is making the electronic tool available to clinicians at multiple locations across Central Florida.

R3 is geared toward healthcare professionals, but will be available to the general public via iTunes and the Android Market. People who think they have been abused can discreetly take the test and find resources to help them.

The HITS test gives physicians a specific set of protocols to follow in pinpointing and treating cases of domestic abuse. Dr. Ademola Adewale, who practices emergency medicine at Florida Hospital, says it’s always tricky when people present with injuries that could signify domestic violence.

“When you see these patients, they’re actually afraid to tell you what really happened, and you actually have to probe more. And if you do probe and you find out something was going on and you’re trying to get the law enforcement involved, and the next thing you know, they’re afraid to tell their story,” Adewale says in the video.

Adewale says the app makes it easier for him to know what he is dealing with, what to evaluate and which questions to ask the patient. “At the same time, I’ll need to know what local resources we have in the community,” he adds.

According to Adewale, only about 30 percent of community physicians actually ask their patients about abuse. “This application makes it easier for them to know the pertinent questions to ask,” he says. “The goal is to identify the patient before they become a victim.”

Given Florida’s large Hispanic population, Harbor House is preparing a Spanish-language version of the R3 App. Wick also envisions providing the app to emergency medical technicians who respond to calls after incidents of domestic violence. She expects the app to gain a foothold worldwide, as Harbor House says that at least one in three of all women around the globe is physically or sexually abused during her lifetime.

Coincidentally, the R3 App’s release comes just as the Department of Health and Human Services is wrapping up a challenge for developers to create apps that will address sexual assault on college campuses. Submissions to that contest were due Monday, and HHS will announce the winners on Oct. 31.

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Study: 26 percent are mobile health users

By: Chris Gullo | Oct 19, 2011        

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iTriage: One of the relatively few health apps that boasts millions of users.

Some 26 percent of US adults used their mobile phones to access health information in the past year, according to a new Cybercitizen Health study by Manhattan Research. The number has nearly doubled from the 12 percent reported in 2010.

According to the study, looking up health information or reading health-related news remains the most popular mobile health activity. The survey polled 8,745 adults online and via phone during the third quarter of 2011.

Another interesting metric: 8 percent of consumers used prescription drug refill or reminder services on their mobile phones, up from 3 percent in 2011.

“Growth in mobile health is impressive, but still in line with our and several health stakeholders’ expectations,” stated Monique Levy, VP of Research at Manhattan Research in a press release. “The interesting part is when, how and from where mobile phones are being used. Getting these details will impact the success of mobile investments in 2011 and 2012.”

While not specifically mobile-related, worth noting that the report found some 56 million US consumers had accessed their medical information on an electronic health record (EHR) system maintained by their physician, with an additional 41 million expressing interest in doing so in the future.

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Wests launch $100 million health investment fund

By: Brian Dolan | Oct 19, 2011        

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Gary and Mary WestGary and Mary West, the co-founders of the West Wireless Health Institute, launched a $100 million investment fund, called the West Health Investment Fund, that will provide capital to cutting edge health care technologies and services that aim to substantially reduce the cost of care. A regulatory filing published last year disclosed that the Wests had already invested in Sotera Wireless, a wearable vital sign monitoring technology startup.

In September 2010 MobiHealthNews reported that West Wireless Health Institute had launched a $100 million venture fund, based on comments made by Qualcomm’s Don Jones at an industry event in London. At the time, the institute told MobiHealthNews that no such fund existed.

Clearly, it does now.

“The Fund is a logical next step for us, as we work to create a vibrant ecosystem around health care innovation to lower health care costs,” Gary West stated in a press release. “Since Mary and I established the West Wireless Health Institute in 2009, we have seen literally hundreds of companies focused on innovative and low cost health care solutions that cannot find funding. Without financial support for low cost health care innovation, the research we do at the Institute and the work other agencies, institutions and entrepreneurs are undertaking will have a tougher path toward becoming a reality and actually lowering health care costs for the public.”

Here’s the type of company or startup the fund is looking to fund:

“The Fund’s areas of interest include health care technologies, data analytics, technology-enabled services, cost transparency, and interoperability,” the press release states. “These areas offer significant opportunities to transform health care delivery and lower health care costs encountered by individuals, health plans, providers and governmental programs like Medicare, Medicaid and the Veterans’ Administration.”

With the launch of the fund, the Wests have announced investments in five other healthcare technology companies:

Biological Dynamics: The company is developing “next-generation diagnostics technology” that could “enable physicians to detect cancer from a simple blood draw and rapidly intervene.” Change Healthcare: The company offers a “web-based decision support tool that provides consumers with personalized views of pricing information and alerts on where to save money on routine healthcare services including medical, dental and prescriptions.” goBalto: Another “web-based solution” that aims to “simplify pharmaceutical, biotechnology and medical device clinical research.” Healthsense: This company offers “monitoring sensors and solutions [that] alert family members and providers of potential health problems before they become acute, enabling seniors to remain healthy and independent.” Humedica: This is “a clinical informatics company whose cutting-edge analytics for health care organizations delivers a truly longitudinal and comprehensive view of patient care.”

Interestingly, most of these companies are not specifically using wireless technology. The focus is on lowering the costs of care instead. Also, and this is perhaps less surprising, Gary and Mary West will not individually profit from the investments made by the West Health Investment Fund — the benefactors plan to commit the fund’s returns to medical research, according to the release. “The structure also differs from a traditional investment fund, as there are no management fees, there is no carried interest, and compensation for the manage­ment team is salaried.”

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Six hospitals deploy AT&T’s emergency care video app

By: Chris Gullo | Oct 19, 2011        

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Screen Shot 2011-10-19 at 1.06.47 PMAT&T and Washington Hospital Center unveiled CodeHeart this week, a platform that allows cardiologists to view video and test results (an ECG, for example) of a patient in transit during critical care situations. The app, which was conceptualized by doctors at Washington Hospital, is available for desktops, tablets, and smartphones.

According to the company, cardiologists can use the app to assess a patient’s physical condition via video link, talk with the patient’s first responder, review test results, and prepare for the patient’s arrival to the emergency room. Videos will be archived for later review.

The app will help the hospital more efficiently distribute its care team and resources since it will be able to determine a patient’s condition before their arrival.

Washington Hospital Center has already rolled out the CodeHeart app at six hospitals. The center serves patients who live as far as hundreds of miles away from Washington D.C., which means enabling physicians and first responders to communicate ahead of time could be a crucial element of the new service.

AT&T recently created a new executive position, Chief Medical Information Officer, and appointed Dr. Geeta Nayyar to it. AT&T has kept busy in the mHealth space, announcing partnerships over the last couple of years with a number of companies, including WellDoc, Vitality, and MedApps. It also recently entered the imaging space with a cloud-based service offering, AT&T Medical Imaging and Information Management service, which launched this summer.

“Washington Hospital Center has been in the forefront in heart care for decades,” stated Lowell Satler, MD, director of Interventional Cardiology at the Hospital Center in a press release. “When it comes to treating a patient who appears to be suffering from chest pain or other heart attack symptoms, every second counts. CodeHeart delivered from AT&T’s network helps us provide optimal care as quickly as possible and effectively treat every heart patient that comes to our facility.”

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